title: Interstitial cells of Cajal: crucial for the development of megacolon in human Chagas' disease?
abstract: OBJECTIVE
  Megacolon, chronic dilation of a colonic segment,is accompanied by extensive myenteric neuron loss. However, this fails to explain unequivocally the formation of megacolon. We aimed to study further enteric structures that are directly or indirectly involved in colonic motility.
  
  
  METHODS
  From surgically removed megacolon segments of seven Chagasic patients, three sets of cryosections from oral, megacolonic and anal zones were immunohistochemically quadruple-stained for smooth-muscle actin (SMA), synaptophysin (SYN, for nerve fibres), S100 (glia) and c-Kit (interstitial cells of Cajal, ICCs). Values of area measurements were related to the appropriate muscle layer areas and these proportions were compared with those of seven non-Chagasic control patients.
  
  
  RESULTS
  Whereas nerve and glia profile proportions did not mirror unequivocally the changes of Chagasic colon calibre (nondilation/dilation/nondilation), the proportions of SMA (i.e. muscle tissue density) and c-Kit (i.e. ICC density) did so: they decreased from the oral to the megacolonic segment but increased to the anal zones (muscle tissue density: control 68.3%, oral 54.3%, mega 42.1%, anal 47.6%; ICC-density: control 1.8%, oral 1.1%, mega 0.4, anal 0.8%).
  
  
  CONCLUSIONS
  Of the parameters evaluated, muscle tissue and ICC densities may be involved in the formation of Chagasic megacolon, although the mechanism of destruction cannot be deduced.
authors.affiliation: Institute of Anatomy I, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Jabari
authors.forename: A B M
authors.initials: AB
authors.lastname: da Silveira
authors.forename: E C
authors.initials: EC
authors.lastname: de Oliveira
authors.forename: K
authors.initials: K
authors.lastname: Quint
authors.forename: A
authors.initials: A
authors.lastname: Wirries
authors.forename: W
authors.initials: W
authors.lastname: Neuhuber
authors.forename: A
authors.initials: A
authors.lastname: Brehmer
mesh_terms: D000199:Actins / Q000032:analysis; D000368:Aged; D016022:Case-Control Studies; D014355:Chagas Disease / Q000150:complications*; D003106:Colon / Q000737:chemistry* / Q000294:innervation; D005260:Female; D006801:Humans; D056885:Interstitial Cells of Cajal / Q000737:chemistry* / Q000473:pathology; D008297:Male; D008531:Megacolon / Q000469:parasitology / Q000473:pathology*; D008875:Middle Aged; D009130:Muscle, Smooth / Q000737:chemistry* / Q000473:pathology; D009197:Myenteric Plexus / Q000737:chemistry; D009457:Neuroglia / Q000737:chemistry; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis; D016708:Synaptophysin / Q000032:analysis
chemical_list: C541116:ACTA2 protein, human; D000199:Actins; D009418:S100 Proteins; C569014:SYP protein, human; D016708:Synaptophysin; D019009:Proto-Oncogene Proteins c-kit
keywords: Chagasic megacolon; enteric glia; enteric nervous system; interstitial cells of Cajal; neurodegeneration; smooth muscle density